Effect of flurbiprofen axetil plus scalp nerve block preemptive analgesia on stress response and postopera-tive pain in patients undergoing craniotomy
OBJECTIVE To explore the effects of flurbiprofen axetil plus scalp nerve block on stress response and postopera-tive pain in patients undergoing craniotomy.METHODS A total of 100 patients undergoing craniotomy were randomized into two groups of scalp nerve block(N,n=50)and flurbiprofen axetil plus scalp nerve block(F,n=50).Group N received 2 mL of normal saline intravenously at 15 min pre-induction of anesthesia while Group F had an intravenous injection of flurbiprofen exfoli-ate at a dose of 1 mg·kg-1 at 15 min pre-induction.In both groups,superior orbital nerve,auriculotemporal nerve,greater occipi-tal nerve and lesser occipital nerve were blocked 10 min pre-operation with 0.5％ropivacaine injection.Intraoperative vital signs were monitored.Mean arterial pressure(MAP)and heart rate(HR)were recorded pre-operation(T0),post-induction(T1),during surgical incision(T2)and immediately post-extubation(T3).Visual analogue scores were assessed at 1 h(T4),6 h(T5),12 h(T6)and 24 h(T7)post-operation.Venous blood samples were collected at T3/T5/T6/T7.And serum levels of norepineph-rine,epinephrine and cortisol were detected by enzyme-linked immunosorbent assay(ELISA).RESULTS Values of MAP and HR were significantly lower in group F than those in group N at all perioperative timepoints(P＜0.05).MAP score was signifi-cantly lower in Group F than that in Group N(P＜0.05).The venous concentrations of cortisol,epinephrine and norepinephrine were significantly lower in Group F than those in Group N at all postoperative timepoints(P＜0.05).CONCLUSION In patients undergoing craniotomy,flurbiprofen axetil plus scalp nerve block for preemptive analgesia has better analgesics than single scalp nerve block and the effect of blunting stress response is superior.
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